4 in 10 Hospitalists Report Unsafe Patient Workloads
The excessive workloads reportedly decreased the time spent on inpatient discussions, and may lead to the ordering of unnecessary test procedures and consultations, Michtalik says.
The authors note that the issue of burnout and high patient workloads leading to errors and adverse outcomes is well known in nursing and in academic residency programs. But they said this research paper is the first to address the issue among hospitalists.
The responses to the survey, administered to 890 self-identified hospitalists who were members of the online physician community QuantiaMD.com, came during four weeks in November, 2010. The researchers said that 57%, or 506, responded. Responses were sought dealing only with daytime shifts.
Michtalik said the survey is the first to "to assess perception of unsafe workload by a direct question, to compare self-reported safe and actual census numbers, and to evaluate the potential impact of inpatient attending physician workload on patient outcomes." He added that several other workforce reports are in the works.
John Nelson, MD, co-founder and past president of the Society of Hospital Medicine, called the Johns Hopkins findings "important," but cautioned that it indicates certified hospitalists "continue to be in short supply throughout much of the country," which may contribute to the negative responses.
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Rick Conrad (1/30/2013 at 4:17 PM)
1. If I remember correctly, JH is a teaching hsopital so each patient could conceivably have an Attending, a Hospitalist and for good measure, and internist. Not a bad ratio of physicians to patients. 2. Nothing was mentioned about Hospitalist enhancers like Practitioners and Nursing staff to lower the physician's intensity. 3. I agree with the comment that one should never let a working Hospitalist manage their schedule.